THE GEOGRAPHY OF HEALTHCARE

MOBILE WOMEN’S HEALTH CLINICS IN TEXAS

Section 1: Highlighting Need

Across the 268,597 square miles of Texas, access to women’s healthcare is deeply uneven. Large regions of the state function as “healthcare deserts,” where high- population communities have few or sometimes no access to nearby clinics providing essential services like contraception, cancer screenings, and preventive care. Many rural Texans face long travel distances, limited transportation options, and months-long wait times.

These barriers make timely, comprehensive healthcare out of reach for many, underscoring the urgent need for solutions that meet people where they are.

That’s where mobile health care units come in.

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Section 2: Health Outcomes.

Learn more.

This is quite important here!

The impact on women’s health has been
especially severe. Nearly half of
Texas counties (46.5%) are classified as
maternity care deserts,
meaning they lack access to
birthing facilities
or maternity care providers altogether.
For thousands of women, even basic
pregnancy care requires
traveling far from home,
4.6% of Texas women live
more than 30 minutes from
the nearest birthing hospital.

Section: Test map switching

Population.

Providers per 1,000.

FPP Providers.

HTW Providers.

Linking to GEOS 3.13.1, GDAL 3.11.4, PROJ 9.7.0; sf_use_s2() is TRUE

{
  const mapId = "test_map";

  // Base layers = radios in addLayersControl(baseGroups=...)
  const baseLabels = [
    "Population",
    "Total Providers per 1,000 Women 15-49"
  ];

  // Overlays = checkboxes in addLayersControl(overlayGroups=...)
  const overlayLabels = [
    "FPP Providers",
    "HTW Providers"
  ];

  const sleep = (ms) => new Promise(r => setTimeout(r, ms));

  function getLeafletMap() {
    const sel = `#${mapId}`;
    try {
      const w = globalThis.HTMLWidgets?.find?.(sel);
      if (w?.getMap) return w.getMap();
    } catch (e) {}
    try {
      const w2 = globalThis.HTMLWidgets?.find?.(mapId);
      if (w2?.getMap) return w2.getMap();
    } catch (e) {}
    return null;
  }

  function getLayerControlRoot() {
    const el = document.getElementById(mapId);
    return el ? el.querySelector(".leaflet-control-layers") : null;
  }

  function getTriggersForSection() {
    const mapEl = document.getElementById(mapId);
    if (!mapEl) return [];
    const section = mapEl.closest(".cr-section") || document;
    return Array.from(section.querySelectorAll(".narrative-col .trigger"));
  }

  function activeTriggerIndex() {
    const triggers = getTriggersForSection();
    if (!triggers.length) return 0;

    const vc = window.innerHeight / 2;
    let bestIdx = 0;
    let bestDist = Infinity;

    for (let i = 0; i < triggers.length; i++) {
      const r = triggers[i].getBoundingClientRect();
      const c = (r.top + r.bottom) / 2;
      const d = Math.abs(c - vc);
      if (d < bestDist) {
        bestDist = d;
        bestIdx = i;
      }
    }
    return Math.max(0, Math.min(3, bestIdx)); // 4 steps
  }

  async function clickRadioByLabel(label) {
    const control = getLayerControlRoot();
    if (!control) return;

    const all = Array.from(control.querySelectorAll("label"));
    const target = all.find(l => (l.textContent || "").trim() === label);
    if (!target) return;

    const input = target.querySelector("input[type='radio']");
    if (input && !input.checked) input.click();
  }

  async function setOverlays({ fpp = false, htw = false }) {
    const map = getLeafletMap();
    if (!map) return;

    // enforce exclusivity between the two overlays
    try { map.hideGroup("FPP Providers"); } catch (e) {}
    try { map.hideGroup("HTW Providers"); } catch (e) {}

    if (fpp) {
      try { map.showGroup("FPP Providers"); } catch (e) {}
    }
    if (htw) {
      try { map.showGroup("HTW Providers"); } catch (e) {}
    }
  }

  async function applyStep(step) {
    // Step plan:
    // 0: Population, overlays off
    // 1: Providers per 1,000, overlays off
    // 2: Providers per 1,000, FPP on
    // 3: Providers per 1,000, HTW on
    if (step === 0) {
      await clickRadioByLabel(baseLabels[0]);
      await setOverlays({ fpp: false, htw: false });
    } else if (step === 1) {
      await clickRadioByLabel(baseLabels[1]);
      await setOverlays({ fpp: false, htw: false });
    } else if (step === 2) {
      await clickRadioByLabel(baseLabels[1]);
      await setOverlays({ fpp: true, htw: false });
    } else if (step === 3) {
      await clickRadioByLabel(baseLabels[1]);
      await setOverlays({ fpp: false, htw: true });
    }
  }

  async function install() {
    // Wait for map + layer control
    for (let i = 0; i < 120; i++) {
      if (getLeafletMap() && getLayerControlRoot()) break;
      await sleep(50);
    }

    const key = "__crStepSwitchInstalled";
    if (globalThis[key]) return null;
    globalThis[key] = true;

    let lastStep = -1;
    let ticking = false;

    const update = async () => {
      ticking = false;
      const step = activeTriggerIndex();
      if (step === lastStep) return;
      lastStep = step;
      await applyStep(step);
    };

    const onScroll = () => {
      if (ticking) return;
      ticking = true;
      requestAnimationFrame(update);
    };

    window.addEventListener("scroll", onScroll, { passive: true });
    window.addEventListener("resize", onScroll, { passive: true });

    // Watch trigger class/style changes (closeread sometimes updates without real scroll)
    const triggers = getTriggersForSection();
    if (triggers.length) {
      const obs = new MutationObserver(onScroll);
      for (const t of triggers) obs.observe(t, { attributes: true, attributeFilter: ["class", "style"] });
    }

    // Initial
    await update();
    return null;
  }

  await install();
  null
}

Section 4: Introduce the concept of mobile clinics

Mobile healthcare units are designed to close gaps by bringing services directly to patients and communities, especially in rural areas. Mobile clinics reduce the distance, time, and cost barriers that prevent many women from accessing care. Mobile clinics set up in trusted community spaces and adapt their routes based on need. They offer a flexible, efficient way to deliver essential women’s health services, such as birth control, cancer screenings, prenatal care, and preventive visits. For women who don’t have reliable access to transportation, mobile clinics can be a literal lifeline. When speaking to patients, they praise the convenience, as they are no longer required to travel hours from home, miss work, school, or childcare. Mobile clinics don’t just expand access; they help ensure care happens earlier, more consistently, and on patients’ terms.

Section 5: Legislation

During the 89th Legislative Session, the Texas Women’s Healthcare Coalition and its partners secured $20 million in new state funding to expand mobile women’s health units across Texas, doubling down on a commitment to meet women where they are. This investment represents $10 million more than the amount secured in 2023, signaling growing legislative recognition of mobile healthcare as a critical solution to access gaps. This funding is the direct result of sustained, collective advocacy and a willingness by providers to find innovative solutions to reach the counties around them.

Section 6: On the road

A single mobile health unit can extend care across multiple counties that aren’t served by brick-and-mortar clinics. This map illustrates how mobile units move across regions with limited or no permanent healthcare infrastructures, reaching women who would otherwise face transportation barriers, or even no access at all.

Section 7: On the ground

Learn more.

Scroll on.

“Now we’re able to do a full clinic, just like a brick-and-mortar clinic, just on wheels.”
— Dr. Perales, DNP, APRN, CNS-BC
Clinic Service Director, STFPHC